Study Hails Precautions At Hospitals

October 25, 1990|By Jean Latz Griffin.

Protecting health-care workers against AIDS and hepatitis by treating all patients as if they are infected costs hundreds of millions of dollars a year. But it is a bargain compared to the alternative of screening patients to find out which ones carry the diseases, according to a study published Wednesday.

The study by the University of Iowa College of Medicine estimates that the nationwide cost of using masks, gloves, gowns and other protective equipment with all patients was $336 million in 1989.

That is higher than an 1989 estimate of $195 million by the federal Occupational Safety and Health Administration, but far below the estimated $2.6 billion it would cost to screen all patients for the AIDS-causing human immunodeficiency virus and hepatitis-B virus, wrote Drs. Bradley Doebbeling and Richard Wenzel, the study`s authors.

``Compared with mandatory testing of all admitted patients, the relative costs of isolation materials used under universal precautions seem

beneficial,`` wrote Doebbeling and Wenzel in this week`s Journal of the American Medical Association.

To assess the cost of extra equipment and procedures, the researchers reviewed purchasing and supply records of the 900-bed University of Iowa Hospital in Iowa City from July 1984 through June 1989-before and after the federal Centers for Disease Control issued their ``universal precautions``

guidelines in August 1987.

Doebbeling and Wenzel calculated the extra cost for that one hospital and extrapolated it nationally to 33.62 million annual patient hospital admissions, 328.8 million outpatient visits to hospitals and 520.8 million visits to physicians.

The extra cost to hospitals was estimated at $269 million for inpatient care and $30 million for outpatient care. Physician cost was estimated at $37 million.

The researchers did not include the cost of training workers to take precautions, the printing of signs and manuals or the disposal of needles. Nor did they include costs to dentists, independent laboratories, nursing homes or paramedics.

``If all these factors were considered, our estimate of the national cost would be conservative,`` they wrote.

At the University of Iowa Hospital, the use of rubber gloves increased to 2.81 million pairs from 1.64 million pairs in the two years after the hospital began treating all patients as if they were potentially infectious. The use of disposable needles and other sharp instruments increased to 25,600 from 10,300, and the use of disposable gowns rose to 91,600 from 83,600 over the same time period.

Only 3 of the 146,746 people who have contracted AIDS since 1980 are health-care workers who became infected after contact with an infected patient`s blood, according to the CDC.

In July the CDC issued a report indicating a Florida patient may have contracted AIDS from her dentist during a dental procedure.